The HIV Client Services EIP provides access to HIV antiretroviral medications, health insurance premiums, and comprehensive medical services for HIV-positive Washington State residents with income at or below 300% of the federal poverty level. In addition to an initial eligibility screening, EIP is also required to recertify clients’ eligibility every 6 months. In 2012, the program received 6,354 applications for consideration; of these, 6,267 were processed, and 4,854 clients were eligible at some point. All individuals applying to EIP for assistance for the first time or after a gap in coverage that exceeds 60 days must complete the full application. The 6-month eligibility review comprises one of two processes: a mini-renewal, in which staff have all needed information on file and complete the required form, or a standard renewal, which involves sending a partially populated form to the client for him or her to complete and return to EIP. Once EIP eligibility is awarded, EIP staff authorize a contracted vendor, EHIP, to make premium payments on behalf of EIP clients and to assist these clients with navigating their options and enrolling in health insurance.
Currently, the wait time is 15–18 days from the time an application is received until eligibility is determined. In the interim, staff need to respond to calls and e-mails from clients and providers regarding eligibility, thus adding a burden to the workload. Moreover, because EIP provides access to life-saving medications, comprehensive health insurance, and medical services, any delays in eligibility could cause health consequences for the individuals these programs are designed to assist. Finally, the more money the program saves by reducing errors, keeping data updated, and avoiding overpayments, the more individuals the program can enroll and serve.